Now that we\u2019ve covered the various types of valvular heart disease, let\u2019s look at it from a different perspective and discuss heart murmurs<\/em>.  Most patients think that a heart murmur and a valve problem are identical, but there are important differences.  Understanding this will help you make sense of why you don\u2019t always need to be concerned about a heart murmur.<\/p>\n\n\n\n

A heart murmur is a sound that is made during the cardiac cycle.  When the ventricles contract (pump), they force the mitral and tricuspid valves to close\u2014this creates what we call the first heart sound (abbreviated \u201cS1\u201d).  The second heart sound (\u201cS2\u201d) occurs when the ventricles start to relax, leading to closure of the aortic and pulmonic valves.  In popular phrasing, we refer to the sounds of S1 and S2 as \u201club-dub.\u201d<\/p>\n\n\n\n

Heart murmurs are extra sounds that occur in between the two heart sounds and usually have a blowing or whooshing quality when listened to with a stethoscope.  Murmurs occur because there is some turbulence in the blood flow.  Think of a river: if the flow is steady and the water isn\u2019t bouncing off rocks or the sides, you don\u2019t hear it.  Only when there is turbulence does the river make noise.  Similarly, we can\u2019t normally hear the blood flowing from one chamber to the next across a heart valve.  But if a valve doesn\u2019t open well (stenosis<\/em>), the normal volume of blood trying to get across that valve moves more turbulently, leading to a heart murmur.  And, if a valve doesn\u2019t close all the way and blood regurgitates<\/em> backward, that blood is also going through a smaller opening (the small residual opening of the incompletely closed valve), which again creates turbulence.  Murmurs can also occur due to holes in the heart\u2014between two chambers\u2014as the blood passing through this opening becomes turbulent.<\/p>\n\n\n\n

So why aren\u2019t murmurs always bad?  If the heart is pumping more blood across the valves\u2014even if they aren\u2019t narrowed\u2014the extra blood flow can lead to turbulence and thus a heart murmur.  Situations where extra blood is being pumped include exercise, pregnancy, if a person is anemic, if a person has a fever, or if the thyroid is overactive, just to name the most common reasons.  Furthermore, heart murmurs can be noted in adolescence, when the body is growing rapidly.<\/p>\n\n\n\n

Another thing to keep in mind is that the loudness of a murmur doesn\u2019t necessarily correspond to how serious the problem is.  People can have a valve that regurgitates or is stenotic\u2014but is not severe and may never become severe\u2014but have a clearly discernible heart murmur.<\/p>\n\n\n\n

Finally, it\u2019s important to keep in mind that murmurs can mean different things at different points in a person\u2019s life.\u00a0 Many people have been told that they had a heart murmur when they were a child or a teenager.\u00a0 When they are noted later in life to have a heart murmur, they may assume \u201cI\u2019ve always had that.\u201d\u00a0 But for the vast majority of people with heart murmurs in childhood or adolescence, the heart murmur goes away once a person is an adult.\u00a0 A heart murmur later in life thus represents something completely different, perhaps a valve that doesn\u2019t open or close properly.<\/p>\n\n\n\n

So, what should a person do who is told he or she has a heart murmur?  Generally, get an echocardiogram\u2014that is the best test to look at the valves and also make sure there is no \u201chole\u201d in the heart.  Once you\u2019ve had that, ask your doctor what is causing the heart murmur.  If it is a valve problem, is it mild or severe?  How likely is it to become severe?  These are all questions that a cardiologist should be able to answer for you.  And, while not all heart murmurs represent a serious problem, it\u2019s important for you to know whether your heart murmur does or doesn\u2019t.  Take the initiative to ask questions and find out.<\/p>\n\n\n\n

Greg Koshkarian, MD, FACC<\/p>\n","protected":false},"excerpt":{"rendered":"

Now that we\u2019ve covered the various types of valvular heart disease, let\u2019s look at it from a different perspective and discuss heart murmurs.  Most patients think that a heart murmur and a valve problem are identical, but there are important differences.  Understanding this will help you make sense of why you don\u2019t always need to be concerned about a heart…<\/p>\n","protected":false},"author":1,"featured_media":1565,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24],"tags":[80,76],"yoast_head":"\n